Hip survival after plain core decompression alone versus bone morphogenetic protein and/or bone marrow reinjection with core decompression for avascular osteonecrosis of the femoral head: a retrospective case control study in ninety two patients

Martinot, Pierre; Dartus, Julien; Leclerc, Jean Thomas; Putman, Sophie; Girard, Julien; Migaud, Henri

doi:10.1007/s00264-020-04692-w

Cited by 12 publications

(17 citation statements)

References 24 publications

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“…The included studies, as classified by their primary authors, were six randomized controlled trials (RCTs) [30][31][32][33][34][35] , three retrospective case-control studies [36][37][38] and two prospective cohort studies. 39,40 However, after careful review based on epidemiological principles of study design, 41,42 these were classified as either controlled observational [36][37][38][39] or interventional 30,32,33,35,40 studies to facilitate subgroup analysis based on study design.…”

Section: Database Searchmentioning

confidence: 99%

“…The weighted average follow-up was 48.2 months, with all studies having a minimum follow-up of 2 years (Table 1). Seven studies 30, 33-36, 38, 40 used the ARCO classification, three followed the Ficat and Arlet classification, 31,32,37 while one study reported data using Steinberg staging. 39 Four studies described multiple drilling CD techniques, whereas single drilling CD was reported in five (Table 1).…”

Section: Demographics Etiologies and Population Matchingmentioning

confidence: 99%

“…30,34,38,40 One study included only patients with post-collapse ARCO stage III of osteonecrosis. 33 In all but three studies, 39,37,40 the preoperative disease stages were matched between the study and control groups (Table 1).…”

Section: Demographics Etiologies and Population Matchingmentioning

confidence: 99%

“…There were nine studies [30][31][32][33][34][35][36][37][38] describing patient cohorts, where biologic augmentation was performed with injection of bone marrow stem cell derivatives (BMSc), containing MNCs (bone marrow mononuclear cells) ranging from an overall number 0.155 x10 9 to 3.0 x10 9 of cells (Table 1). Liu 38 used both BMSc and a bone filling material (granular porous nanohydroxyapatite/polyamide 66 composite) to enhance local cell entrapment and integration.…”

Section: Types Of Augmentationmentioning

confidence: 99%

“…Yang 39 also used structural augmentation implanting a biomaterial-loaded allograft threaded cage with a diameter of 16 mm and containing bone morphogenetic protein (BMP). Martinot 37 included two experimental cohorts with BMSc, with one having received additional BMP (Table 1). Aggarwal 40 was the only study that investigated the effect of platelet-rich plasma (PRP) augmentation.…”

Section: Types Of Augmentationmentioning

confidence: 99%

See 4 more Smart Citations

Lack of Conclusive Evidence of the Benefit of Biologic Augmentation in Core Decompression for Nontraumatic Osteonecrosis of the Femoral Head: A Systematic Review

Andronic

Hincapié

Burkhard

et al. 2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Database Searchmentioning

confidence: 99%

Section: Demographics Etiologies and Population Matchingmentioning

confidence: 99%

Section: Demographics Etiologies and Population Matchingmentioning

confidence: 99%

Section: Types Of Augmentationmentioning

confidence: 99%

Section: Types Of Augmentationmentioning

confidence: 99%

See 3 more Smart Citations

Lack of Conclusive Evidence of the Benefit of Biologic Augmentation in Core Decompression for Nontraumatic Osteonecrosis of the Femoral Head: A Systematic Review

Andronic

Hincapié

Burkhard

et al. 2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Orthobiologic therapies delay the need for hip arthroplasty in patients with avascular necrosis of the femoral head: A systematic review and survival analysis

Zaffagnini,

Boffa,

Andriolo

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this systematic review and survival analysis was to quantify the benefits of orthobiologic augmentation therapies for the treatment of avascular necrosis (AVN) of the femoral head and identify the most effective approach to delay the need for total hip arthroplasty (THA).MethodsA systematic review of the literature was performed on PubMed, Scopus, and Cochrane on clinical studies on orthobiologic therapies used alone or as an augmentation to core decompression or other procedures to address hip AVN. A qualitative analysis of the different biological therapies applied was performed. Afterward, the results of these procedures were quantitatively analysed to document their survivorship from THA compared to treatment groups without orthobiologics. Kaplan–Meier analysis was performed for all studies and then by categorising orthobiologics into treatment subgroups.ResultsA total of 106 studies were included (4505 patients). Different orthobiologic approaches have been evaluated: cell‐based therapies including bone marrow aspirate concentrate (BMAC) and bone marrow mesenchymal stromal cells (BM‐MSCs), platelet‐rich plasma (PRP), or other bioactive molecules applied in the osteonecrotic area or as intra‐arterial injections. The survival analysis at 120 months documented a higher (p < 0.0005) cumulative survivorship with orthobiologics (69.4%) compared to controls (48.5%). The superiority was shown specifically for BMAC (p < 0.0005), BM‐MSCs (p < 0.0005), intra‐arterial (p < 0.0005) and PRP (p = 0.011) approaches, but the direct comparison of these approaches with their controls confirmed benefits only for BMAC (p < 0.0005).ConclusionThis systematic review and survival analysis demonstrated that orthobiologics have the potential to improve survivorship in patients affected by hip AVN. In particular, the specific analysis of different orthobiologic products supported relevant benefits for BMAC augmentation in terms of survival from the need for THA, while no clear benefits were confirmed for other orthobiologics.Level of EvidenceLevel III.

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Avascular Necrosis of the Hip

Dubé,

Emara,

Piuzzi

2024

Orthopaedics and Trauma

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Hip survival after plain core decompression alone versus bone morphogenetic protein and/or bone marrow reinjection with core decompression for avascular osteonecrosis of the femoral head: a retrospective case control study in ninety two patients

Cited by 12 publications

References 24 publications

Lack of Conclusive Evidence of the Benefit of Biologic Augmentation in Core Decompression for Nontraumatic Osteonecrosis of the Femoral Head: A Systematic Review

Lack of Conclusive Evidence of the Benefit of Biologic Augmentation in Core Decompression for Nontraumatic Osteonecrosis of the Femoral Head: A Systematic Review

Orthobiologic therapies delay the need for hip arthroplasty in patients with avascular necrosis of the femoral head: A systematic review and survival analysis

Avascular Necrosis of the Hip

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